He remained tight-lipped about his clients but admitted he’s had everyone from
builders and plumbers to City execs and politicians in for surgery.

Here he reveals why the demand for these procedures is on the rise.

“MY clients tend to be in their 30s or 40s — although we’ve had men close to
20 and some men in their 70s decide to have the penoplasty operation.

They come from all walks of life — labourers, office workers, politicians, you
name it.

For most, it’s not a functional problem. They simply feel self-conscious in
the gym changing room or when wearing swimming trunks.

They want the £4,000 lengthening operation to make them feel more confident,
although those opting for the £3,850 girth enlargement can expect benefits
for a partner, which can obviously enhance their whole relationship as well
as their sex life.

I’d say around 80 per cent of my patients want to increase girth and length at
the same time, costing £6,000. Penoplasty can increase flaccid length by one
to one and a quarter inches and the circumference by about the same.

Now, I know some men — and women — will be amused at what they perceive as
self-indulgence.

But it’s more fundamental than that. I know what a positive effect the surgery
can have on a man’s self-esteem.

I’ve been performing these surgeries for more than two decades and know how
in-demand it is. I perform around 300 penoplasty ops a year, comparable to
the number of ‘moob’ operations carried out nationwide in the UK.

Since I started, I would estimate I’ve performed upwards of 3,000 penis
enlargements and know from the feedback that it’s a very successful op.

We can barely keep up with the demand and I’m not afraid to turn away patients
if they have unrealistic expectations.

Risks In fact, until a couple of years ago we were carrying out up to 15
penoplasty operations a week, but had to scale that back so we could fit all
the other procedures we carry out into our surgery schedule.

But it still accounts for a large proportion of the work I do.

Do I think demand is on the increase? Absolutely. Just ten or 20 years ago men
weren’t allowed to admit to anyone their insecurities about their appearance
and now more men are having cosmetic surgical procedures, so it’s only
natural that penis enlargement figures within that.

For millennia, having a bigger penis has been a status symbol, a sign of
strength or masculinity, and it’s only very recently that men have been able
to do something about that. If there’s a solution, why not use it?

Although we have refined our technique, the procedure has remained roughly the
same. The girth is increased with injections of fat from other parts of the
body. Lengthening is achieved by cutting the ligament that anchors the penis
to the pelvis.

There are rare medical conditions that can result in the penis not growing as
it should. In these cases, penoplasty is not suitable and a complex
reconstructive procedure is required.

There are risks. In fewer than five per cent of cases the fat can form into
lumps, cysts or hard nodules, causing unevenness, although this is not
usually permanent and can be corrected.

The procedure, which takes about 90 minutes, is carried out under sedation so
patients can return home the same day. First we take a small amount of blood
and use a centrifuge to separate out cells known as platelets.

We believe these slow the fat re-absorption process — although lengthening is
permanent, the girth enlargement lasts for two to five years, after which it
has to be repeated.

The equivalent of six tablespoons of fat is harvested from the patient’s
abdomen or flanks using a syringe.

We wash and filter it, then inject it at the base of the penis. Remaining fat
can be frozen and stored for future top-ups. The central part of the penis
is the corpora cavernosa, two sponge-like regions that fill with blood
during an erection.

These, and the urethra, which carries urine from the bladder, are surrounded
by layers of fascia — tough tissue. The fat graft sits between two of the
fascia and does not affect function.

During the lengthening part of the op, which can be done at the same time, we
make a small incision through which we cut the suspensory ligament that
attaches the organ to the pelvis.

When it is flaccid, some of the shaft sits inside the body. By cutting the
ligament, more hangs outside.

No implant or graft is used so there is no difference to the length when erect
— although the angle may not be as acute as it once was. The operation takes
around an hour. Afterwards, no bandages are worn, just loose-fitting
underwear.

Patients need to abstain from vigorous activity for about three weeks but
after that it is back to normal. The small scar is barely visible.

Even those with partners often don’t tell them they have had the operation.
The results are so natural that you would never know.

Why do so few surgeons carry out penis enlargements? Because there’s no formal
training for it.

I’ve developed and honed my technique using surgical methods from different
surgeries to put together a procedure I think is reliable and safe.

We also offer counselling before and after surgery to make sure our patients
are mentally prepared for the reality and don’t have or develop any
underlying psychological issues.

Would I have this operation myself? Yes, if I felt I needed it but I’m happy
with what nature gave me.

You have to look at the whole picture. Many people see Michelangelo’s David as
a perfect specimen of manhood and I doubt if anyone would describe him as
well-endowed.

Fortunately for men who aren’t content, there are other options.”

Roberto runs the London Centre for Aesthetic Surgery in Harley Street, London.
There are also surgeries in Dublin and Dubai. See lcas.com.

Steven Cass, 42

STEVEN, a decorator, lives with his secretary wife Sarah, 40, in Bristol.
He claims a makeover downstairs gave his sex life a boost. He says:

“ASK any man if he hasn’t thought about the size of his manhood or compared it
to other guys’ penises in the changing rooms and I know what the answer will
be.

I never became depressed over the size of my penis, I just felt insecure
getting changed in front of men. I also knew I was below average and thought
having a bigger penis might be appreciated by my wife.

About two years ago I read a piece in a magazine about an operation to make me
bigger. I’d recently inherited a bit of money and could afford the £5,000
price tag.

Just before Christmas in 2011, I went to the London Centre for Aesthetic
Surgery in Harley Street for a consultation.

The surgeon emphasised my flaccid penis would be longer but there’d be no
difference in length erect, but with fat transfer it would be thicker. I
opted for both operations in one.

A month later I had the op – it took just over an hour. I was quite sore for
several days, with some bruising around my groin.

But I couldn’t stop staring in the mirror – I’d gone from a 3cm flaccid penis
to more than 5cm and the girth almost doubled.

I felt completely different, like everything about me had changed, and it had
a really positive knock-on effect on my confidence.

I’d told Sarah I was having the op and, while she thought I was silly to take
risks with surgery, she was really impressed.

She said sex was better too but that might’ve been because I felt more
confident. It became more frequent and lasted longer.

I told my best friend, who was genuinely amazed but he said he felt perfectly
happy the way he was and wouldn’t contemplate it.

Two years on, the girth has reduced but it’s still way bigger than before. I
don’t regret having it done and am only a bit annoyed with myself for not
getting it done sooner.

Of course you have to make sure you choose the right surgeon. If I’d felt they
were being pushy, or the surgeon wasn’t competent, I wouldn’t have had it
done.”

James Smith, 24

JAMES, a plumber, from Birmingham, was too ashamed to shower at the gym
before an op to extend his manhood. He says:

“I HAD a real complex about the size of my manhood. I wasn’t confident enough
to chat to girls.

I worried that if I did get one back to my bedroom, she’d take one look and
run a mile.

I started searching the internet for what you could do to make it bigger. Then
I came across an article about penoplasty. Fat from another part of your
body is used to either lengthen or thicken the penis.

It was a lot of money – £3,000 – but I was willing to do anything to get a bit
more confidence. The size of my manhood was ruining my life.

It took me two years to save up but once I had enough money I booked an
appointment at the London Centre for Aesthetic Surgery. I felt really
reassured after talking to the surgeon and decided to go ahead with the
operation.

They took fat from my stomach and used it to thicken my penis. It was red
afterwards but not bruised. I walked away from the clinic a few hours later
hoping this was going to change my life.

It was painful at first and I was told I couldn’t have sex for two weeks but
that wasn’t a problem as I wasn’t having sex anyway.

I was thrilled with the results and felt like a man for the first time in my
life. No one had ever said I was small but I was also trying to measure up
to other men. I’m an avid gym-goer but I always went home to shower as I was
too ashamed of my penis to let anyone else see it.

Now, I’m happy getting changed in the changing rooms. I have to go back for
the occasional top-up to make sure I stay in shape but my life has been
changed.

I’ve just started dating a wonderful girl. I’ve not told her about the op but
I hope if things get a bit more serious and I decide to tell her, she’ll
understand.”

Name has been changed to protect identity.

Paul Hamilton, 30

PAUL, 30, had an enlargement after worrying about the size and shape of his
manhood.

The social media manager, from Putney, south west London, reckons it has
made him confident about his body for the first time in his life. He says:

“I’VE always been self-conscious about my looks and compared myself to men
with large packages, such as David Beckham.

Even though I felt good about my facial appearance and hair, there was one
thing that really bothered me – and it was down below.

As far as I was aware, it wasn’t small but it wasn’t big. I avoided getting
changed in front of other men at the gym.

Single at the time, I made enquiries about surgery after reading about it in a
magazine. I was sure if my penis was bigger, my love life would change.
Though ex-girlfriends had never commented on my size, it still bothered me.

I had my first consultation with a surgeon at the London Centre for Aesthetic
Surgery in May 2011. I was talked through the procedure of widening my penis
and risks such as infection and bleeding – and my concerns were put at ease.
The idea of putting a needle full of fat into my private parts didn’t
exactly fill me with joy but I knew that was my only option.

I booked the procedure. It was pricey, at £3,000, but it was worth it. It was
strange to think fat from my belly was being put in my privates but it
didn’t bother me.

When the numbing wore off, I was thrilled. It was at least 50 per cent wider.
I felt like my insecurities were a thing of the past.

Since having the procedure a year ago, I’ve met a lovely girl called Claire,
who’s 27. She’s never commented on the size or shape of my penis but we have
great sex.

It’s more intense than before my op and much more satisfying. Whether that’s
because I’m more confident or because the op means the fat in my penis
restricts blood flow and intensifies it, I’m not sure.

I have to go to the clinic every few months to have fat transferred but I
don’t mind.

I think the fat should eventually stay put and I’ll be left with a bigger
manhood. No one knows I’ve had the op, not even Claire, but I’ve put my
insecurities to bed.”